Organization
HEART TO HEART RESIDENTIAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAKIA HAYES-CONWAY (ADMINISTRATIVE DIRECTOR)
(804) 833-0873
Entity
Organization
Contact information
Practice address
2115 N WHITEHILL DR, PETERSBURG, VA 23803-3731
(804) 833-0873
Mailing address
6012 MOONLIGHT DR, NORTH CHESTERFIELD, VA 23234-4620
(804) 833-0873
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
1821-01-001
VA
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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